Recurrent miscarriage (RM; ³3 consecutive early pregnancy losses) affects around 1% of fertile couples. Parental
chromosomal anomalies, maternal thrombophilic disorders and structural uterine anomalies have been directly
associated with recurrent miscarriage; however, in the vast majority of cases the pathophysiology remains
unknown. We have updated the ESHRE Special Interest Group for Early Pregnancy (SIGEP) protocol for the
investigation and medical management of RM. Based on the data of recently published large randomized controlled
trials (RCTs) and meta-analyses, we recommend that basic investigations of a couple presenting with recurrent
miscarriage should include obstetric and family history, age, BMI and exposure to toxins, full blood count,
antiphospholipid antibodies (lupus anticoagulant and anticardiolipin antibodies), parental karyotype, pelvic ultrasound
and/or hysterosalpingogram. Other investigations should be limited to particular cases and/or used within
research programmes. Tender loving care and health advice are the only interventions that do not require more
RCTs. All other proposed therapies, which require more investigations, are of no proven benefit or are associated
with more harm than good.
Odgovori s citatom